{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:16:28Z","timestamp":1777335388109,"version":"3.51.4"},"reference-count":27,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2016,11,24]],"date-time":"2016-11-24T00:00:00Z","timestamp":1479945600000},"content-version":"vor","delay-in-days":846,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,8,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>The aim of this population-based study was to evaluate the clinical and pathological characteristics and outcome of papillary thyroid carcinoma (PTC) that have arisen in the Belarusian childhood population exposed to the radioactive fallout from the Chernobyl accident within a long-term period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods:<\/jats:title><jats:p>The long-term treatment results were investigated in 1078 children and adolescents (&amp;lt;19 years old) with PTC who were surgically treated during the years 1990 through 2005.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>Patients had high rates of metastatic PTC at presentation, with 73.8% of cases having lymph node involvement and 11.1% having distant spread. The most influential factor for lymph node metastases at initial treatment was lymphatic vessel invasion (P &amp;lt; .0001) and for distant metastases, lateral lymph node involvement (P &amp;lt; .0001). The overall survival was 96.9% \u00b1 0.9% with a median follow-up of 16.21 years, and 20-year event-free survival and relapse-free survival were 87.8% \u00b1 1.6% and 92.3% \u00b1 0.9%, respectively. Patients had significantly lower probability of both loco-regional (P &amp;lt; .001) and distant relapses (P = .005) after total thyroidectomy (TT) and radioactive iodine therapy (RAI). For loco-regional relapses after TT, only RAI influenced the prognosis significantly (P &amp;lt; .001). For distant relapses after TT, the refusal to treat with RAI (hazard ratio [HR] = 9.26), vascular invasion (HR = 8.68), and age at presentation (HR = 6.13) were significant risk factors. For loco-regional relapses after non-TT, the principal risk factors were age less than 15 years old at presentation (HR = 5.34) and multifocal growth of tumor (HR = 5.19). For distant relapses after non-TT, the lateral neck metastases were the only unfavorable factor (HR = 9.26).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>The outcome of PTC both in children and in adolescents exposed to the post-Chernobyl radioiodine fallout was rather favorable. TT with RAI is recommended for minimizing loco-regional or distant relapses.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2013-3131","type":"journal-article","created":{"date-parts":[[2014,5,13]],"date-time":"2014-05-13T17:56:47Z","timestamp":1400003807000},"page":"2932-2941","source":"Crossref","is-referenced-by-count":23,"title":["Initial Presentation and Late Results of Treatment of Post-Chernobyl Papillary Thyroid Carcinoma in Children and Adolescents of Belarus"],"prefix":"10.1210","volume":"99","author":[{"given":"Mikhail","family":"Fridman","sequence":"first","affiliation":[{"name":"Department of Pathology, Republican Centre for Thyroid Tumors (M.F., S.M., Y.D.), Minsk, Belarus 220013"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natallia","family":"Savva","sequence":"additional","affiliation":[{"name":"Research and Clinical Center for Children With Head Abnormalities and Nervous System Disorders (N.S.), Pediatric Palliative Care Department, Moscow, Russian Federation 107143"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Krasko","sequence":"additional","affiliation":[{"name":"United Institute of Informatics Problems (O.K.), National Academy of Sciences of Belarus, Minsk, Belarus 220012"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svetlana","family":"Mankovskaya","sequence":"additional","affiliation":[{"name":"Department of Pathology, Republican Centre for Thyroid Tumors (M.F., S.M., Y.D.), Minsk, Belarus 220013"},{"name":"Institute of Physiology (S.M.), National Academy of Sciences of Belarus, Minsk, Belarus 220013"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel I.","family":"Branovan","sequence":"additional","affiliation":[{"name":"Project Chernobyl Inc (D.I.B.), Brooklyn, New York 11235"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt W.","family":"Schmid","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Neuropathology (K.W.S.), University Hospital of Essen, University of Duisburg-Essen, Essen, Germany 45147"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Demidchik","sequence":"additional","affiliation":[{"name":"Department of Pathology, Republican Centre for Thyroid Tumors (M.F., S.M., Y.D.), Minsk, Belarus 220013"},{"name":"Belarusian Medical Academy of Post-Graduate Education (M.F., Y.D.), Minsk, Belarus 22013"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","reference":[{"issue":"4","key":"2020071614051491700_B1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.clon.2011.01.178","article-title":"Clinical presentation and clinical outcomes in Chernobyl-related paediatric thyroid cancers: what do we know now? What can we expect in the future?","volume":"23","author":"Tuttle","year":"2011","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"2020071614051491700_B2","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.clon.2011.01.510","article-title":"The Chernobyl accident\u2014an epidemiological perspective","volume":"23","author":"Cardis","year":"2011","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"2020071614051491700_B3","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/01.sla.0000205977.74806.0b","article-title":"Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus","volume":"243","author":"Demidchik","year":"2006","journal-title":"Ann Surg"},{"key":"2020071614051491700_B4","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1038\/onc.2009.349","article-title":"Radiation carcinogenesis: lessons from Chernobyl","volume":"27","author":"Williams","year":"2008","journal-title":"Oncogene"},{"issue":"4","key":"2020071614051491700_B5","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.clon.2011.01.160","article-title":"The Chernobyl thyroid cancer experience: pathology","volume":"23","author":"LiVolsi","year":"2011","journal-title":"Clin Oncol (R Coll Radiol)"},{"issue":"4","key":"2020071614051491700_B6","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.clon.2011.01.502","article-title":"The Chernobyl Accident and its Consequences","volume":"23","author":"Saenko","year":"2011","journal-title":"Clin Oncol (R Coll Radiol)"},{"issue":"7","key":"2020071614051491700_B7","doi-asserted-by":"crossref","first-page":"3039","DOI":"10.1210\/jc.2013-1059","article-title":"Twenty-five years after Chernobyl: outcome of radioiodine treatment in children and adolescents with very high-risk radiation-induced differentiated thyroid carcinoma","volume":"98","author":"Reiners","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614051491700_B8","first-page":"3563","article-title":"Post-Chernobyl thyroid carcinoma in Belarus children and adolescents: comparison with naturally occurring thyroid carcinoma in Italy and France","volume":"82","author":"Pacini","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2020071614051491700_B9","article-title":"Cancer Staging Manual","author":"American Joint Committee on Cancer","year":"2010","edition":"7th ed"},{"key":"2020071614051491700_B10","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1214\/aos\/1176350951","article-title":"A class of K-sample tests for comparing the cumulative incidence of a competing risk","volume":"16","author":"Gray","year":"1988","journal-title":"Ann Stat"},{"key":"2020071614051491700_B11","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A proportional hazards model for the subdistribution of a competing risk","volume":"94","author":"Fine","year":"1999","journal-title":"J Am Stat Assoc"},{"key":"2020071614051491700_B12","unstructured":"Therneau T . Survival Analysis. R package version 2.37\u20134. http:\/\/CRAN.R-project.org\/package=survival. ; 2013Accessed May 22, 2014."},{"key":"2020071614051491700_B13","unstructured":"Gray B . Subdistribution Analysis of Competing Risks. R package version 2.2\u20136. http:\/\/CRAN.R-project.org\/package=cmprsk. Accessed May 22, 2014; 2013."},{"key":"2020071614051491700_B14","doi-asserted-by":"crossref","unstructured":"Varadhan R , KukD. Stepwise Covariate Selection for the Fine & Gray Competing Risks Regression Model. R package version 2013\u201302.12. http:\/\/CRAN.R-project.org\/package=crrstep. ; 2013Accessed May 22, 2014.","DOI":"10.32614\/CRAN.package.crrstep"},{"key":"2020071614051491700_B15","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s00428-011-1161-3","article-title":"Intratumoural lymph vessel density is related to presence of lymph node metastases and separates encapsulated from infiltrative papillary thyroid carcinoma","volume":"459","author":"Eloy","year":"2011","journal-title":"Virchows Arch"},{"key":"2020071614051491700_B16","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1038\/modpathol.2011.119","article-title":"Pathological definition and clinical significance of vascular invasion in thyroid carcinomas of follicular epithelial derivation","volume":"24","author":"Mete","year":"2011","journal-title":"Mod Pathol"},{"key":"2020071614051491700_B17","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/j.1365-2559.2011.03791.x","article-title":"Desmoplastic stromal reaction in papillary thyroid microcarcinoma","volume":"58","author":"Koperek","year":"2011","journal-title":"Histopathology"},{"key":"2020071614051491700_B18","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1038\/modpathol.2009.38","article-title":"Survival impact of psammoma body, stromal calcification, and bone formation in papillary thyroid carcinoma","volume":"22","author":"Bai","year":"2009","journal-title":"Mod Pathol"},{"key":"2020071614051491700_B19","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1089\/thy.2008.0270","article-title":"Prognostic factors affecting neck lymph node recurrence and distant metastasis in papillary microcarcinoma of the thyroid: results of a study in 445 patients","volume":"19","author":"Mercante","year":"2009","journal-title":"Thyroid"},{"issue":"10","key":"2020071614051491700_B20","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1002\/cncr.11362","article-title":"Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence","volume":"97","author":"Acharya","year":"2003","journal-title":"Cancer"},{"issue":"5","key":"2020071614051491700_B21","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1089\/thy.2008.0343","article-title":"Clinical behavior of radiation-induced thyroid cancer: factors related to recurrence","volume":"19","author":"Naing","year":"2009","journal-title":"Thyroid"},{"issue":"4","key":"2020071614051491700_B22","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1001\/archoto.2009.13","article-title":"Influence of previous radiation exposure on pathologic features and clinical outcome in patients with thyroid cancer","volume":"135","author":"Seaberg","year":"2009","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2020071614051491700_B23","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.jpeds.2008.11.059","article-title":"Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents","volume":"154","author":"Lazar","year":"2009","journal-title":"J Pediatr"},{"key":"2020071614051491700_B24","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1007\/s002590000271","article-title":"Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children","volume":"27","author":"Jarzab","year":"2000","journal-title":"Eur J Nucl Med"},{"key":"2020071614051491700_B25","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1046\/j.1365-2265.1998.00584.x","article-title":"Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults","volume":"49","author":"Dinauer","year":"1997","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2020071614051491700_B26","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00268-012-1558-4","article-title":"Clinical features, treatment, and long-term outcome of papillary thyroid cancer in children and adolescents without radiation exposure","volume":"36","author":"Enomoto","year":"2012","journal-title":"World J Surg"},{"issue":"10","key":"2020071614051491700_B27","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1089\/thy.2011.0005","article-title":"Clinical and pathologic features of \u201csporadic\u201d papillary thyroid carcinoma registered in the years 2005 to 2008 in children and adolescents of Belarus","volume":"22","author":"Fridman","year":"2012","journal-title":"Thyroid"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/99\/8\/2932\/20288614\/jcem2932.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/99\/8\/2932\/20288614\/jcem2932.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T22:17:27Z","timestamp":1746224247000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/99\/8\/2932\/2538332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8,1]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,8,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2013-3131","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8,1]]}}}